New St. Joseph wing opens after years of planning, construction; resulting urgent care closure raises concerns about higher costs

St. Joseph Hospital in Eureka opened its new Northeast Wing this week, after several years of planning, construction, and delays.

Thirty-four patients were moved into the 100,000-square-foot addition, and the emergency department also opened.

"We're thrilled to be in there," said hospital spokeswoman Leslie Broomall.

Planning for the project started in 2000, and ground was broken in 2007. She said the hospital now has three "wings" -- one built in 1954, one in 1997, and the most recent. The new addition means the hospital's urgent care clinic will close in January, which has raised some concerns about higher costs for those seeking treatment for minor ailments.

The $145 million project is the result of an unfunded state mandate requiring all California hospitals to comply with updated seismic laws by 2013. The original hospital -- built in 1954 -- was not compliant, necessitating the addition, Broomall said.

The seismic law for hospitals was passed by the state Legislature after the Northridge earthquake in 1994, said California Hospital Association spokeswoman Jan Emerson-Shea. Originally, those improvements were to be made by 2008.

"It became clear many hospitals weren't going to be able to meet the 2008 deadline," she said. About 40 percent of hospital buildings in the state had to be rebuilt, she said, and the total estimated cost was $110 billion. The deadline for hospitals was pushed back to 2013, with some extensions.

"Hospitals had to figure out how to pay for it on their own," Emerson-Shea said.

Broomall said the law applies to inpatient acute care, so other hospital services -- like registration, the laboratory and cafeteria -- will still be in the old wing.

Broomall said the overall number of beds in St. Joseph isn't changing. She said a few new jobs may be added due to the addition, but "not a huge number."

The new wing also includes an expanded ER with 20 beds.

In a letter to the editor, St. Joseph urgent care nurse Roxanne Spencer wrote that the current ER and urgent care have a combined total 19 beds, so the net gain of the new all-inclusive emergency department will be one bed. The hospital's urgent care clinic -- aimed at patients with minor injuries and illness like sore throats, the flu, or sports injuries -- will close on Jan. 5.

"If they can't see (a patient), they'll send them to urgent care," Spencer said. "I just think it's a horrible thing they're doing for the community."

Carol Reeder, hospital vice president and chief nursing officer, said last week that all patients will be seen in the new facility, regardless of injury or illness. That leaves some in the community concerned about a possible increased price tag for patients with lesser issues that now must check into the ER at St. Joseph.

"The less acute patient will be billed less," Reeder said last Friday. "There will be somewhat similar charges as currently in urgent care."

Spencer wrote in her letter that there will be some higher costs.

"Every patient seen in the new emergency department will be charged an emergency department room rate and physician rate, which are both higher than urgent care visits," she wrote. "Those patients fortunate enough to have insurance will have much higher co-pays."

She said St. Joseph employees have a $25 co-pay in urgent care, but will now have to pay $50 to be seen in the new ER.

"People that realize how much more you spend in the ER are really upset," said urgent care nurse Donna McQueen. She said she's seen a patient who came to St. Joseph to receive a basic treatment for poison oak. The first time, when he checked into the ER, he told McQueen he paid $1,300. In urgent care, the same treatment cost him $300.

Without knowing specifics, Emerson-Shea said she wasn't surprised St. Joseph was rolling urgent care and the emergency room into the same department -- both to save money and streamline service -- especially as the hospital opens a costly new wing.

"Many hospitals, if they're going to be rebuilding anyway, they're deciding how health care is going to be delivered differently." She said she's seen many hospitals moving in the same direction.

Last March, St. Joseph CEO Joe Mark said in a memorandum to staff members that despite previous plans to close the urgent care clinic, the hospital would not be doing so after "members of our community raised concerns that this consolidation would potentially increase out of pocket expenses for urgent care treatment."

Last Thursday, a memorandum from Reeder went out to hospital staff, saying that after much review of patient and resource needs, the hospital had decided to close the urgent care clinic.

Noelle Camarena, a nurse at Eureka Community Health Clinic, said the clinic offers services similar to the St. Joseph Urgent Care Clinic.

"We expect to see an increase," in patients after it closes, she said. "I'm not sure what to expect."